<?xml version="1.0" encoding="utf-8"?>

<div xmlns="http://www.w3.org/1999/xhtml" component="$UI/system/components/justep/window/window" xid="window" design="device:mobile">  
  <div component="$UI/system/components/justep/model/model" xid="model" onLoad="modelLoad" style="height:auto;left:141px;top:3px;"> 
    <div component="$UI/system/components/justep/data/data" autoLoad="true"
      xid="data" idColumn="id"> 
      <column label="id" name="id" type="String" xid="default1"/>  
      <column label="content" name="content" type="String" xid="default2"/>  
      <column label="title" name="title" type="String" xid="default4"/>  
      <column label="wDate" name="wDate" type="String" xid="default5"/> 
    </div> 
  </div>  
  <span component="$UI/system/components/justep/windowReceiver/windowReceiver"
    xid="windowReceiver" style="left:94px;top:30px;"/>  
  <span component="$UI/system/components/justep/windowReceiver/windowReceiver"
    xid="windowReceiver1" style="left:215px;top:17px;"/>  
  <div component="$UI/system/components/justep/panel/panel" class="x-panel x-full"> 
    <div class="x-panel-top"> 
      <div component="$UI/system/components/justep/titleBar/titleBar" class="x-titlebar"> 
        <div class="x-titlebar-left x-titlebar-title"> 
          <a component="$UI/system/components/justep/button/button" label=""
            class="btn btn-link btn-only-icon" icon="icon-chevron-left" onClick="backBtnClick"
            xid="backBtn"> 
            <i class="icon-chevron-left"/> 报修填报
          </a>  
          <div class="x-titlebar-right"> 
            <a component="$UI/system/components/justep/button/button" class="btn btn-default btn-only-icon"
              label="button" xid="button3" icon="icon-android-checkmark" style="background:none;border:none;float:right;margin-right:10px;"> 
              <i xid="i3" class="icon-android-checkmark"/> 
            </a> 
          </div> 
        </div> 
      </div> 
    </div>  
    <div class="x-panel-content"> 
      <form style="margin-top:20px;padding:0 10px 0 10px;"> 
        <div class="form-group"> 
          <div component="$UI/system/components/justep/row/row" class="x-row"
            xid="row1" style="padding:0 0 0 0;margin: 0 0 0 0;"> 
            <div class="col-xs-6" xid="col1" style="padding:0 0 0 0;margin: 0 0 0 0;">  
           	   <label>姓名</label>  
               <input type="text" class="form-control" id="name" placeholder="请输入姓名"/> 
            </div>
            <div class="col-xs-6" xid="col1">  
           	   <label>房号</label>  
               <input type="text" class="form-control" id="number" placeholder="请输入房号"/> 
            </div>
          </div>
        </div>  
        <div class="form-group"> 
          <label>报修内容</label>  
          <textarea component="$UI/system/components/justep/textarea/textarea" class="form-control" placeholder="请输入报修内容" xid="content"/>
        </div>
        
        <div class="form-group"> 
          <label>备注</label>  
          <textarea component="$UI/system/components/justep/textarea/textarea" class="form-control" placeholder="请输入备注信息" xid="remark"/>
        </div>  
   
        <div class="form-group"> 
          <label>受理状态</label>  
          <select class="form-control" xid="state" id=""> 
            <option>请选择受理状态</option>  
            <option>类型1</option>  
            <option>类型2</option>  
            <option>类型3</option>  
            <option>类型4</option> 
          </select> 
        </div> 
        
        <div class="form-group"> 
          <label>维修人员</label>  
          <input type="text" class="form-control" id="serviceman" placeholder="请输入维修人员"/> 
        </div>  
        <div class="form-group"> 
          <label>上门时间</label>  
          <input type="text" class="form-control" id="servicetime" placeholder="请选择上门时间"/> 
        </div>  
        <div class="form-group"> 
          <label>处理结果</label>  
          <input type="text" class="form-control" id="result" placeholder="请选择处理结果"/> 
        </div>  
        
      </form> 
    </div> 
  </div> 
</div>
